Minutiae of my every day since 2004.

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Friday, September 8, 2017

My dilemma with the oral exams came from the fact that, days before the test, I wasn’t feeling stressed at all. I was almost indifferent; I had just wanted to get past the almost-three hours of dealing with complicated paper case vignettes, of enumerating obscure differentials to otherwise common chief complaints, and of making sure I wouldn’t miss out on acute coronary syndrome as a differential for a diabetic who presents with abdominal pain. I’d done this many times, once as an intern (we had a case of chronic obstructive pulmonary disease), then twice as a medical resident, but the gnawing feeling of thinking on the spot, in front of mentors I’ve looked up to even as a student, would not go away, like the discomfort of a shard of meat stuck in between one’s incisors.

One can always argue that this should come easy, thinking and charting being the theme of our lives, after all. We have spent much of my waking hours in the hospital, dealing and managing problems of real people, making sense of their laboratories as they became available, and so on. Real life is more difficult, true, but the challenge of the paper case is different. The urgency to generate a working impression just by skimming through a long case, the ability to retrieve a gazillion differentials from one’s memory bank without a second to spare, the disappointment with one’s self for hearing the bell (“time is up!”) without finishing the discussions on the ideal management plans—these put a lot of pressure in someone.

Indifference necessarily leads to failure. I kept on finishing episodes of Madam Secretary (Netflix) instead of reviewing. Basically I was readying myself for an appointment with the training committee. When I saw the roster of consultants posted in front of the exam venue a day before September 7, my emotional chronotropic incompetence was overcome. Like a reflex, I texted my study buddy Racquel Bruno to join me for coffee and practice sessions after work—and Ulysses Gopez would later join us, too, in generating differentials from out of nowhere. We had quite a productive night, having run through the case vignettes that our colleagues had shared. The study session prematurely ended when sleepiness got the better of me at 9:30 PM.

By God’s grace, I had a good night’s rest. And the exam was as hard as I had expected, but it’s over now. Praise be to God.

Café Ilang-Ilang, our usual post-oral exam haunt, had prepared 20 tables for us. The buffet was amazing, effectively ruining my diet for the day. I stuffed myself with mussels, cold cuts, salads, and whatever looked expensive. With the comfortable, boisterous company of people I've come to call my friends; my heart was filled to overflowing.

I’m sharing some of my favorite photos from lunch.

Carlos and Rich discuss their answers in the exams, prime examples of people who never move on.

Friends from my table share a light laughter. Bea must have said something funny, and we see one of the extremely rare occasions when Doc Abby loses her poise.

David and Roger, meeting clandestinely. (That's your word for the day, David!)